Physicians for Sport

From the high school level to the professional ranks, team physicians play an integral, yet largely anonymous, role in sports. They are buried in the back pages of team media guides and are rarely remembered in post-game interviews or championship speeches. But they are crucial to the success of our teams and the health of our favorite players.

Team physicians provide care for athletes and enable them to reach their full potential. They manage in-game injuries and coordinate the treatment and rehabilitation to help competitors return to action.

“It’s a lot of the roles you’d expect,” says Damion Valletta, D.O.’99, who has worked as a team physician at the high school, collegiate and Olympic levels. “Team physicians provide counsel on a player’s readiness to play and the likelihood of further injury. We make recommendations to the strength and conditioning coach and the coaching staff, who make the final decision.”

“There’s a lot of pressure. You are looking out for the safety of the athlete,” claims James Weber, D.O.’91, a boxing ringside physician for six years. “It’s not easy. What may look like a minor injury may actually be very bad underneath the surface.

“The team physician concept varies by level,” continues Weber. “At the pro level, it’s less fun. Politics get involved. Athletes aren’t thinking in their best interest or looking out for their long-term health and safety. But the amateur level is fun because you’re doing good.”

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A golden opportunity

Damion Valletta, D.O.’99, works with U.S. Women’s soccer stars like Abby Wamback and Hope Solo during time away from his San Diego orthopedic sports medicine practice.

Every aspiring soccer player dreams of taking the pitch for Team USA on the world’s biggest stage. For Damion Valletta, that dream became a reality last August, albeit as a team physician, not a player. A senior member of the medical staff, he was in Wembley Stadium as the U.S. Women’s National Team (USWNT) took home the gold in the London Olympics.

Valletta has been with the USWNT through the highs (that gold in London) and the lows (2011’s shootout loss to Japan in the World Cup final). It’s all been a remarkable experience for the lifelong soccer fan. But it was a matter of being in the right place at the right time that led to his golden memory.

“I got involved doing East Coast soccer matches during my fellowship at Penn. My first event was a men’s World Cup qualifier in Washington, DC,” tells Valletta. “A lot of the doctors were based out west and had difficulty traveling for East Coast matches. I was able to fill in.”

His first big match under his belt, Valletta covered five or six more events, working mostly with the younger national teams in both the men’s and women’s programs. Turnover in the medical staff presented new opportunities and, in 2008, he was asked to travel for a USWNT match in Portugal. He has been with the team ever since.

“My basic responsibilities involve understanding the players’ health condition, monitoring their overall well-being and injuries and preparing them to play. Players need you as a resource on whether they should or shouldn’t play,” Valletta says. “There are a lot of regulations, too, so there’s an administrative side to it. You need to adhere to FIFA [Federation Internationale de Football Association] guidelines and know the ins and outs of the banned substance list. You represent your players during drug testing by making sure the integrity of the sample is preserved.”

With athletes of the highest caliber and matches of increasing importance, you’d expect enormous pressure to get them on the field. Valletta sees none of that. “If it’s a significant injury, I pull them,” he says. “I’ve never been questioned in my time with the team. If they understand why you’re making the decision, they’re okay with it.”

When it comes to a player’s readiness to play, the decision is ultimately left up to the coaches. If a player is limited but medically cleared, the head coach makes the call based on the importance of the match as well as upcoming matches. Sometimes it

comes down to the player’s mental state. The nation’s best players are competing for a limited number of roster spots. Coaches understand the player’s psyche and whether being out an extended period of time will make them uncomfortable.

“I speak with the coaches and staff about injuries. We discuss both the medical and psychological concerns with the injury. Most of the time it’s not black and white. The question is ‘Do you want them at 80 percent now or 100 percent in six weeks?’” Valletta says. “There are a lot of incidental injuries. Players were held out in the Olympic year to make sure they were back in time for Olympic matches. It was very strategic to let them heal and save them for major matches.

“I worked with these girls for years. Alex Morgan, I traveled with her for four years. It’s impressive to see how the girls grow and watch them evolve as people and players over that time,” adds Valletta.

From the hills of Des Moines to the slopes of the Alps

Craig McKirgan, D.O.’88, balances his role as team physician for the U.S. Men’s Alpine Ski Team with his career as an orthopedic surgeon in Indiana, PA.

Craig McKirgan, D.O.’88, grew up in Des Moines, where the closest thing to a ski slope is a hilly street right after a winter snowstorm. He didn’t even strap on his first pair of skis until his freshman year at Iowa State University when, on a whim, he went with a group of friends to Colorado for spring break. Never a ski bum or even an enthusiast, McKirgan is still heading to the mountains several times a year as a team physician for the U.S. Men’s Alpine Ski Team.

“As physicians, we assess the athletes, but we talk with them, the athletic trainers and the coaches – it’s a team effort,” says McKirgan. “If an athlete has an injury, we make them show they are okay. They must show they can withstand the stress and prove that the knee can hold up.”

McKirgan served as a member of the medical team for the 1996 Olympics in Atlanta and the 2003 Pan American Games in the Dominican Republic. A fellow team member mentioned an opening with the U.S. Ski Team. Despite his limited skiing experience, he jumped at the opportunity to continue working with Olympic-level athletes.

The job has taken McKirgan to events across the globe. Each winter, he travels with the team to World Cup events in places like Austria, France and Switzerland. Next March, he will likely be headed back to Switzerland for the International Ski Federation (FIS) World Cup Final Championships.

Exotic locations aside, the ski events are no vacation; they require a lot of work and preparation.

McKirgan goes to the venue the weekend before to survey the situation. He visits the local and regional hospitals as well as the major trauma center in the area. It’s a necessary process that familiarizes him with his new surroundings and gives him a chance to speak to local physicians and surgeons.

“In the event an accident occurs, you want to know everything. There’s a lot of logistics in what we do,” he says. “If something should happen, we must have a plan. A lot of what we do is preparing for that.”

The threat of a catastrophic accident is very real on the slopes. The mountains are injected with water to make the course faster – and more dangerous. In the blink of an eye, an athlete can go from a perfect run to a frightening fall. Team physicians and ski patrol are strategically stationed along the course, ready to provide care at a moment’s notice.

“The skiers move so fast that you only see them for about 15 seconds before they are out of sight,” says McKirgan. “We’re on skis carrying backpacks with medical kits. When someone goes down, it’s radioed to us to ski down and provide assistance. We stay with the athlete from the moment they get hurt throughout the entire medical process.

“These guys are going extremely fast – 85 miles an hour – down a mountain on ice. One fall can lead to traumatic injuries,” he continues. “Our principal job is to make sure someone doesn’t die. A lot of times we have to use a helicopter to transport them to the nearest hospital, especially in the Alps.”

Striking a delicate balance

Providing care for the world’s best athletes and traveling to international competitions are the biggest perqs of working for Team USA. But the job has its disadvantages. A physician has to balance his or her commitment as a team doc with the demands of a full-time medical practice.

For Valletta, that means vacation time becomes travel time with the team. A rotating crew of physicians ensures each event is covered, but certain venues such as World Cup or Olympic qualifiers require the experience of senior medical staff.

“It’s unrealistic for my private practice to be put on hold for every event. I pick four to five weeks a year to travel with the team, based on the biggest need and venue,” he says.

Managing the practice while on the road is critical. Valletta finds a way to be there for every appointment via an iPad in the exam room. He can view MRIs, digital images and all other patient information and get updates from the staff. The patients can talk to him via FaceTime if they have questions or concerns. It is not ideal for an orthopedic practice, but Valletta credits a great office staff for making it all possible.

Balance is also an issue for McKirgan. He travels to Europe for a week or more every winter for competitions and covers parts of training back in the U.S. And he still has to find time to keep his skills sharp.

“I have to keep up with skiing one or two times a year for practice,” McKirgan says. “We are required to go through special training in the U.S. Every few years, we have a mountain rescue course, which involves a lot of trauma care training.”

Time spent away from the office clearly comes at a price to a team physician’s practice. But the additional training and experience working with top athletes and physicians provide unique learning opportunities that can be applied back home.

“Meeting with doctors from other countries is helpful. You learn how they treat injuries and how their system of medicine works,” says McKirgan. “You get different perspectives – little things you never thought about. I might hear about a different surgical technique and think, ‘That’s interesting. Maybe I’ll try that.’”

Valletta agrees. “I get to work at the highest level of sports medicine. Over time, you find some good tricks that trickle down to your practice.”

A part of the team

Leading up to the 2008 Olympics, the United States was the favorite for the gold in women’s soccer. A month before the Beijing Games, the team had an exhibition match against Brazil in Valletta’s home city, San Diego. Thirty-one minutes into the match, the USWNT suffered a devastating loss when leading scorer Abby Wambach broke her left tibia and fibula in a violent collision with a defender.

“The next morning, I did Abby’s surgery. We knew right then her Olympics were over,” says Valletta, who inserted a titanium rod into Wambach’s leg. “When we won in 2012, Abby was so appreciative. I was able to take care of her and get her back to health,

and she won a gold medal.” In fact, this June, Wambach became the all-time leading scorer in women’s soccer history with 159 international goals, one more than previous record-holder Mia Hamm.

Moments like her successful surgery validate all the hard work and time spent with the team. Physicians are with the athletes around the clock. They attend practice and events, eat meals and stay in the same hotels as the athletes. With all that time together, the team becomes like a family.

“The best part about being a team physician is the relationships you develop with the staff, coaches, trainers and athletes,” says McKirgan. “You get to see the athletes develop. It’s really neat to see that progression. It’s a great opportunity and a privilege. I’m very lucky.”

“In the big picture, it’s a great experience. The Women’s National Team is a group of professional girls who work hard to be the best and are very appreciative of the fan support they receive,” adds Valletta. “Building up that trust with the athletes and staff is one of the most valuable things I’ve accomplished over the years.”

Climbing the ranks of the boxing world

James Weber, D.O.’91, pictured here with undisputed World Champion Floyd Mayweather, went from treating the injuries of big-name fighters to negotiating with them to bring bouts to Michigan.

As a physician for USA Boxing and professional bouts, James Weber, D.O.’91, sat ringside for world title fights featuring boxing heavyweights like Chris Byrd, Evander Holyfield and Wladimir Klitschko. But his career as a ringside physician was short-lived.

Five years ago, Weber was approached by Michigan Governor Jennifer Granholm to draft H.B. 4869, a bill to make mixed martial arts (MMA) a regulated sport in the state. The bill passed and he was appointed state commissioner in the Department of Energy, Labor and Economic Growth. His new job was to oversee the licensure and regulation of combat sports in Michigan, which presented a conflict of interest with being a ringside physician.

“My job is to bring bouts to the state. It’s all about generating revenue for the state,” says Weber. “I deal with promoters, networks, merchandisers, policymakers, bureaucrats and the governor. I’ve become a glorified politician.”

A former amateur boxer himself, Weber’s background as a physician, researcher and ringside doc landed him the job. In 2011, he was reappointed by Governor Rick Snyder as the chairman of the Unarmed Combat Commission within the Department of Licensing and Regulatory Affairs. With two years left in his second term, he already has his next move planned: a return to boxing. He will assume an executive director role with the World Boxing Council (WBC), based in Mexico City.

“The WBC is known for the heralded green belt. Every fighter wants that title. It translates to money for the athletes, large arenas and pay-per-view money for TV,” he says.

Once Weber assumes his role with the WBC, he will focus on fighter safety and work with the ringside physicians to ensure they are properly trained. His time as a ringside physician helped shape that.

“As a ringside doc, I thought, ‘Wow, we don’t know squat about head injuries.’ What is a concussion? What can I do with this athlete?” questions Weber. “It’s not an easy decision.

“I recognize there’s not a lot of good data and athletes are dying. What can we do to protect against head injuries?” he continues. “If I have the skill set, I should be advancing the agenda. I will make my career advancing the sport. What we’re doing is saving lives, and I’m proud of that.”